GIC: Part IV: The (Sleepy) Voyage Home

So a week ago I was sat in my bedroom enjoying a lazy weekend, as I’m known to do, when my phone pinged with a text message. It turned out to be an automated NHS reminder, noting that I had a gender identity clinic (GIC) appointment in exactly 48 hours.

I paused. Taking a moment to process what that meant. I hadn’t misread it, that was a new appointment, one I had no idea existed until seconds ago. Oh dear.

For those who don’t know, I live around 250 miles away from my GIC, which is back up in the North. Due to having moved a year after joining the waitlist, I have to make the trip every time I have an appointment. Awkwardly, it’s not easy to get up there on short notice, and it’s not too cheap either.

My first reaction upon seeing the appointment message was to wonder if it was even real. Well, that was actually my second reaction, my first being to curse loudly and groan with exhaustion at the idea of having to spend my Sunday traveling. In the past the GIC have always sent me a letter first, with a month’s notice. So I tried to think what was more likely; that the text reminder system was glitching up for a canceled or fake appointment, perhaps due to a mischievous A.I. or disgruntled employee, or my letter had simply been lost in the post.

The letter had probably gotten lost, right? That made a lot more sense. Still, I wanted to do what I could to find out before I made any plans.

The GIC was closed and wouldn’t be open until Monday, the day of my appointment. Which was rather inconvenient. Thankfully, a friend did find a switchboard phone number and accompanying e-mail address for the overarching group which runs the GIC.

That’s the benefit of having considerate friends, along with a tendency to overshare on Twitter, you often end up being able to crowdsource solutions in a minor crisis like this.

I just got a text from the GIC saying I have an appointment on Monday. This is the first I've heard about it. I now have 1 day to travel up.

Once I finally got through to the switchboard, they explained they couldn’t contact the doctor or access the GIC system. They had no way to confirm the appointment whatsoever, but did note it was possible the text system was malfunctioning. This initially left me even more confused about what to do, but I realised despite the advice, I still wanted to go.

When the clinic is so strict about removing people for cancellations, it instills a healthy dose of paranoia in you. Thus I accepted that my weekend was ending early.

The next thing I did was to get in touch with work, via an apologetic text message, and arrange to take the days off. The perks of working in a fairly casual and understanding office is that people are generally understanding about last minute issues like this, so I wasn’t too overwhelmingly guilty about vanishing so suddenly.

Finally, I had to figure out how I was actually going to get up there. I costed up a bunch of different scenarios, thinking about the different ways and different days to travel. My first idea was to head up on Sunday, so I shot off a message to my parents asking if it would be okay if I just turned up tomorrow and stayed the night in my old bedroom. Well that plan was incinerated by a big “Nah” from them. Deciding to process that parental rejection at a later date, I started to think about my other options.

I was already dreading the idea of going all the way up and staying the night. As Retta had just started a job trial, a rare one that might be able to work around her fibromyalgia(!), she couldn’t risk taking any last minute time off to tag along. That meant I’d be sleeping alone, and I’m absolutely terrible at getting to sleep alone. I’m one of those people who will stare into darkness for hours, pondering the mysteries of existence as sunrise approaches. For whatever reason, if someone is sleeping next to me then I drop to sleep in minutes. Apparently I find people calming?That left my remaining options as either a hotel, or having to ask a friend to lend me their most comfortable couch on ridiculously short notice.

Although I know some lovely people, and I’m sure they wouldn’t mind my sudden imposition, it’s not something I felt comfortable doing without a little more warning. The alternative was to do the whole 500 mile trip in a single day. An awkward but not impossible plan, thanks to my GIC appointment having been scheduled for the afternoon.

Checking what would happen if I got up early and headed straight there, I realised I could arrive a whole 2 hours before my appointment. Perfect. At least, it would be perfect if none of my trains got delayed.Monday morning came and I crawled out of bed at 5:30AM and rolled right into an early taxi. Forgetting there’s not exactly much traffic around at that time, as most people have the common sense to still be asleep, we breezed down to the station in minutes. Once there I sat blearily on the platform waiting for my first train to London.

This photo actually came out really dark and uninteresting, so I set the vibrancy and contrast to “so high it’s practically green.” Enjoy!

Once in London, as soon as the clock hit 9:00AM, I phoned the GIC. Delightfully, I got confirmation that the appointment was real and not a mistake, so at least I could make the rest of the journey without worrying I was going up for no reason (I was only slightly disappointed I didn’t get an excuse to spend the day wandering around London instead).

As I’d done my usual strategy of maximising my time in bed, I’d set off without any makeup on that morning and had just wrapped a baggy hoody over my dress. Not keen on arriving to my appointment looking like an especially disheveled swamp hag, I used my spare time to squeeze onto a bench, shed my hoody, and pop my makeup on. I had to smile at the realisation of what I was doing, as an army of commuters dashed by me. It was such a mundane and simple thing, to sit applying makeup in public while wearing a colourful buttoned dress, but 3 years ago I’d have been far too anxious to do it without being painfully self-conscious.

I’m always surprised by the realisation of how recently it was that I was still apprehensive to present so comfortably in public. A year before we moved to the coast, I would avoid eye contact and manoeuvre around in a shy shuffle, when wearing something overtly feminine. I would trade confidence for comfort, yet in a post-HRT world, dressing how I please leads me to be more confident and more comfortable than any other period of my life. I try remind myself of this juxtaposition when I can, to underline that even mundane everyday things can be seen as reasons to be proud of myself in a wider context.

Breaking out of that cycle of nervous fear was the best thing I ever did. It’s why when people reach out to me and say they can’t imagine ever being confident enough to present how they want to so openly, I say with conviction that I know they will. If I can go from that nervous shadow to who I am now, happily chatting to a stranger in a busy train station, then anyone can.

After 90 minutes of snapping photos, daydreaming, making temporary friends, and tinkering with my phone, I was greeted by an announcement that my train had been delayed. I won’t lie, I was a little concerned and joined in with the grumpy expressions of my fellow passengers. But before I could curse my decision to trust the British rail system, the train pulled in and I was able to scuttle aboard.

Although I had packed my phone and Kindle with endless entertainment, paranoid I’d be gripped with boredom on the train, I mostly ended up staring blankly out of the window and playing with Spotify playlists. I arrived at the GIC a couple of hours later, still with about an hour to kill before my appointment. Not a bad result for a 250 mile trip!

As I walked in for the actual appointment, I was asked if I knew what I was there for. To that I just laughed and explained how I had no idea why I was here because I didn’t even know the appointment existed until exactly 48 hours ago. It turned out the appointment was for hormones.

Apparently a letter had been sent out last month (another that I didn’t get) to explain that I’d been diagnosed with gender dysphoria and as expected, had breezed through the (weirdly patronising) assessment process, which had begun last September.I talked about this a bit on Twitter, but I have mixed feelings about this.

On one hand, it’s good to have my diagnosis as that unlocks NHS care for me and gives me an actual confirmed diagnosis to fall back on if I ever need it. Not that I think an NHS letter is going to be much use outside of the NHS, but yknow. It’s nice to have some other evidence that vouches for me, beyond my passport’s ‘F’.

Do I think gender dysphoria should even be a diagnosis? I’m not convinced it should be. Being trans is not an illness. Considering it a type of mental illness awkwardly implies some falsehoods about being trans. I’ve heard calls to place trans healthcare somewhere else, in its own category, and honestly I support that instead. Gender dysphoria is horrible, but it’s also something very personal, it affects different people in different ways and is triggered by different factors. It’s not a psychiatric condition and it’s not treated like a typical mental illness.

I’m not sure what the solution is on the whole diagnosis issue, but I suppose that’s a topic for another day.

So as for the appointment itself, I got told my GP will now be heavily pressured to prescribe me HRT herself, rather than leaving it to me to rely on my private doctor. I pointed out my GP has been reluctant in the past to monitor my levels herself, but the doctor essentially said they’ll be writing to her and impressing upon her the importance of prescribing, especially the fact that it’s her duty to learn how to. Luckily, I have a batch of HRT to last me a while if this takes some time to negotiate with my GP.

Ridiculously, I completely forgot to ask about funding for laser. This was something I’d been told would be coming once I had my diagnosis, but I just entirely forgot to bring it up. I’ve made a note to contact them about it next week and find out if they’ll handle some of the cost as promised.

TMI warning: Although I’ve finished the laser sessions for my face, pre-surgery laser is starting now and that’s just as expensive (though oddly not as painful!). So that money will really come in handy.

The journey back to the coast was considerably different than my journey up, at least in how I felt. Although I was fairly relaxed on the way to London, once I got back there I was grouchily ready to head to sleep. But I still had nearly two hours to wait in a draughty coach station and another two hours to sit on the coach itself.

After initially sitting next to someone who coughed with such dramatic furore I was starting to wonder if they had seconds left to live, I decided to go find a quiet corner to sit in so I could phone Retta and fill her in on how my appointment went. Gradually time slogged on until it was time to go and catch my coach.

The final leg of the trip was a strange blur, as I dipped in and out of sleep and shambled zombie-like into my final taxi of the day. As I got home I went right to bed and munched on a pile of nachos as I fell to sleep, the only food I could find that didn’t involve more brainpower to prepare than I had left.

By then it was into Tuesday morning, and I’d woken up almost 24 hours ago. But thankfully it had worked. I successfully made the trip in a day without any problems.

Although everything went fine, I’ll admit I do hope I get a little more notice next time!

About The Author

Mia describes herself as a twenty-something trans woman and total geek. You can find her on Twitter at @OhMiaGod, where she talks about life, trans issues and comic books. If you want to help support her and this website, you can also find her on Patreon.

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2 Comments

Not sure how this post passed me by, Mia… a bit like your appointment letter I suppose. Must be something in the air!

I’ve also realised that the ‘official’ diagnosis is a pivotal moment in the process, as it’s not until then that the GIC machinery really kicks in – hormonally or practically. Even in these enlightened times it seems that only a doctor can pronounce a diagnosis, despite the fact that nurses seem to run the NHS for most of the time.

I’ve heard – don’t know for certain if it’s true – that gender dysphoria remains classified as an “illness” in the world’s medical lexicon for the benefit of our sisters in the USA. Defined “Illnesses” are covered by medical insurance, and if yours isn’t on the list then you’re on your own financially. It’s a plausible theory, anyway.

Yeah, the diagnosis is really what separates you from “officially” being someone who’s just investigating if they’re trans, to someone who is 100% verified transgender and now eligible for NHS care. It’s unfortunate that gatekeeping still exists like that, but I won’t repeat myself!

Also yeah, the diagnosis thing and insurance, it’s a tricky one. I did some reading and apparently there’s been proposals to move trans healthcare into a new umbrella of its own, something that acknowledges it’s not a mental illness, but a complicated state that can require both mental and physical treatment. Though I know even that has been contested, as there seems to be little agreement. I’m not sure what the solution is really.